People with skin cancer at higher risk for other types

Skin cancer usually is so easily cured that Luvie Owens almost forgot she had it.But results of a major new study are giving her cause for concern: Women who have had the most common forms of skin cancer are 2.3 times as likely to also get deadlier cancers such as breast, lung and colon. Among African-American women, the risk of getting other cancers is 7.5 times higher.

The study didn't include men, but smaller studies found that male skin cancer patients also are at higher risk for other cancers.

The new study included 93,658 women ages 50 to 79 who volunteered for the Women's Health Initiative, a federal research project of postmenopausal women. Results are being published online today in Cancer, a journal of the American Cancer Society.

Skin cancer affects more than 1 million Americans a year and accounts for half of all cancers.

The most common skin cancers, known as non-melanoma, are almost always curable with minor surgery. But a less common form, melanoma, can be fatal if not caught early. Melanoma skin cancers account for only 4 percent of skin cancer cases but 79 percent of deaths.

The study compared women who have had non-melanoma skin cancers with those who haven't, and controlled for such factors as age, ethnicity and socioeconomics.

Among women with no history of skin cancer, 11.7 percent reported they had experienced other cancers. Among those who have had skin cancer, 24.9 percent had experienced other cancers.

Ultraviolet sunlight and tanning lamps can cause skin cancer by damaging cell DNA or suppressing the immune system. It's possible that ultraviolet light, when combined with other cancer triggers such as viruses, also can lead to other types of cancer, said the study's lead author, Dr. Carol Rosenberg of Evanston Northwestern Healthcare.

The results could prompt plastic surgeons and dermatologists to revise their advice to patients. For example, Evanston Northwestern plastic surgeon Dr. Gordon Derman said he now plans to warn his skin cancer patients they may be at a higher risk for other cancers. He said he will advise them to talk to their primary care doctors about the risk.

The study also should provide extra incentives for skin cancer patients to get cancer screening tests such as mammograms, colonoscopies and Pap smears, Rosenberg said.

Owens, 70, plans to get a long-overdue colonoscopy, which screens for cancer of the colon and rectum.

The Winnetka resident had minor surgery 18 months ago to remove a non-melanoma skin cancer from her back. "I was told to forget it," she recalled. "It was a big fat nothing."

Now it's something to think about. "It's not the kind of thing I will stay up worrying about," she said. "But some people will."

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